Minor depression as a cardiac risk factor after coronary artery bypass surgery.
Identifieur interne : 004080 ( Main/Merge ); précédent : 004079; suivant : 004081Minor depression as a cardiac risk factor after coronary artery bypass surgery.
Auteurs : Chiara Rafanelli [Italie] ; Renzo Roncuzzi ; Yuri MilaneschiSource :
- Psychosomatics [ 0033-3182 ]
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Complications postopératoires, Femelle, Humains, Indice de gravité médicale, Mâle, Pontage aortocoronarien (psychologie), Rôle de malade, Sujet âgé, Sujet âgé de 80 ans ou plus, Trouble dépressif (diagnostic), Trouble dépressif (épidémiologie), Trouble dépressif (étiologie), Troubles psychosomatiques (diagnostic), Troubles psychosomatiques (épidémiologie), Études de suivi, Études prospectives.
- MESH :
- diagnostic : Trouble dépressif, Troubles psychosomatiques.
- psychologie : Pontage aortocoronarien.
- épidémiologie : Trouble dépressif, Troubles psychosomatiques.
- étiologie : Trouble dépressif.
- Adulte d'âge moyen, Complications postopératoires, Femelle, Humains, Indice de gravité médicale, Mâle, Rôle de malade, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Coronary Artery Bypass (psychology), Depressive Disorder (diagnosis), Depressive Disorder (epidemiology), Depressive Disorder (etiology), Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications, Prospective Studies, Psychophysiologic Disorders (diagnosis), Psychophysiologic Disorders (epidemiology), Severity of Illness Index, Sick Role.
- MESH :
- diagnosis : Depressive Disorder, Psychophysiologic Disorders.
- epidemiology : Depressive Disorder, Psychophysiologic Disorders.
- etiology : Depressive Disorder.
- psychology : Coronary Artery Bypass.
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications, Prospective Studies, Severity of Illness Index, Sick Role.
Abstract
A few studies have investigated the role of psychosocial variables on clinical outcomes in coronary artery bypass grafting patients. The aims of this prospective study were 1) to assess clinical and subclinical distress in a consecutive sample of patients who underwent coronary artery bypass grafting surgery at both a 1-month assessment and a 6- to 8-year follow-up visit; and 2) to investigate the relationship between psychological variables and coronary events. A consecutive series of 47 patients with recent coronary artery bypass grafting surgery was evaluated by means of observer-rated categories (both the Diagnostic and Statistical Manual [DSM] and the new Diagnostic Criteria for Psychosomatic Research [DCPR]), and self-rated scales such as the Psychosocial Index. Survival analysis was used to characterize the clinical course of patients at the 6- to 8-year follow-up. One month after surgery, at the first psychological assessment, 36% of patients received a psychiatric diagnosis, and almost half of the sample met the criteria for a DCPR cluster. At follow-up, only abnormal illness behavior scores varied significantly from those at the first evaluation. Among the variables examined as potential risk factors for coronary events, only minor depression attained statistical significance. Psychological evaluation of patients who underwent coronary artery bypass grafting surgery needs to incorporate both clinical (DSM) and subclinical (DCPR) methods of classification. Furthermore, the data suggest minor depression as a potential cardiac risk factor in coronary artery bypass grafting patients. The clinical approach to coronary artery bypass grafting patients should thus include not only major depressive symptoms but also minor depression.
DOI: 10.1176/appi.psy.47.4.289
PubMed: 16844886
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pubmed:16844886Le document en format XML
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<front><div type="abstract" xml:lang="en">A few studies have investigated the role of psychosocial variables on clinical outcomes in coronary artery bypass grafting patients. The aims of this prospective study were 1) to assess clinical and subclinical distress in a consecutive sample of patients who underwent coronary artery bypass grafting surgery at both a 1-month assessment and a 6- to 8-year follow-up visit; and 2) to investigate the relationship between psychological variables and coronary events. A consecutive series of 47 patients with recent coronary artery bypass grafting surgery was evaluated by means of observer-rated categories (both the Diagnostic and Statistical Manual [DSM] and the new Diagnostic Criteria for Psychosomatic Research [DCPR]), and self-rated scales such as the Psychosocial Index. Survival analysis was used to characterize the clinical course of patients at the 6- to 8-year follow-up. One month after surgery, at the first psychological assessment, 36% of patients received a psychiatric diagnosis, and almost half of the sample met the criteria for a DCPR cluster. At follow-up, only abnormal illness behavior scores varied significantly from those at the first evaluation. Among the variables examined as potential risk factors for coronary events, only minor depression attained statistical significance. Psychological evaluation of patients who underwent coronary artery bypass grafting surgery needs to incorporate both clinical (DSM) and subclinical (DCPR) methods of classification. Furthermore, the data suggest minor depression as a potential cardiac risk factor in coronary artery bypass grafting patients. The clinical approach to coronary artery bypass grafting patients should thus include not only major depressive symptoms but also minor depression.</div>
</front>
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